TL neuro

June 30, 2015

Smokers have to adapt to e-cigarettes to maximize nicotine yield

Filed under: Cannabis, Public Health, Tobacco/Nicotine — mtaffe @ 1:20 pm

One of the reasons that smoked/inhaled drug delivery is highly associated with addiction is that this route allows humans to exquisitely titrate their dosing. Thus for drugs like nicotine that become aversive at higher doses, smoking tobacco in several punctate inhalations over a short interval of time permits the user to avoid unpleasant dose levels.

This contrasts, for example, with buccal administration. If anyone recalls sampling chewing tobacco as a youth, you will understand what I mean. The relatively slowed onset and the larger available dose of the wad of tobacco or snuff packed up against the gums is frequently associated with severe nausea in the naive user.

A similar situation obtains with cannabis for which smoking has been the preferred route of administration. There is, however, relatively familiar use of cannabis via the oral route- think pot brownies. Increasingly, the medical marijuana entities are also selling a variety of edibles for oral administration of marijuana. Again, it is relatively common for naive consumers of edible products to overdose because the subjective effects hit long after a ballistic, irreversible drug administration has been accomplished.

A recent paper on the use of e-cigarettes for cannabis delivery (Etter, 2015) piqued my interest because it suggested that experienced cannabis smokers did not really like the e-cigarette delivery all that much.

Presentations at the recent CPDD meeting referred to the fact that nicotine seekers who use e-cigarette devices have to learn to adjust their inhalation behavior relative to their tobacco smoking. This is described in a paper that I located:

Farsalinos KE, Spyrou A, Stefopoulos C, Tsimopoulou K, Kourkoveli P, Tsiapras D, Kyrzopoulos S, Poulas K, Voudris V. Nicotine absorption from electronic cigarette use: comparison between experienced consumers (vapers) and naïve users (smokers). Sci Rep. 2015 Jun 17;5:11269. doi: 10.1038/srep11269.

Farsalinos15-nicotine-experiencedvapersThe authors examined e-cigarette (EC) use in groups of ex-smokers who had quit and had been using ECs for at least a month and another group of smokers who were not EC users (available for free at PMC here). Subjects were asked to take 10 puffs from a standardized EC device in the first five minutes and then use it at their own discretion for another hour. The study sampled their blood for nicotine levels that were achieved across the study and the key figure from this paper is depicted here. As you can see, the experienced EC users (vapers) reached higher plasma nicotine levels than did the EC-inexperienced smokers. Each group averaged the same number of puffs, around 85-90, but the experience vapers took longer puffs (3.5 vs 2.3 seconds).

The simple interpretation is that if nicotine amount is a function of vapor cloud volume, and delivery across the lungs depends on retention time within the lungs, then longer puffs would result in greater nicotine delivery. The slightly more complex issue, mentioned at the CPDD annual meeting but not addressed in this paper, is that the rate at which a user inhales can be important. The idea is that if you pull too much of the EC vehicle across the heating element it can cool the element, resulting in lower nicotine yield.

Bottom line, EC inhalation for maximum nicotine yield and tobacco smoke inhalation for maximum nicotine yield may require a different inhalation approach.

This then reminds us that when ECs are adapted for crude cannabis extracts or even other drugs, it will require users to learn to adapt their behavior for idealized drug yield before we truly understand the risks. An initial report like Etter (2015) showing cannabis users don’t like to use ECs to deliver THC as well as they like to smoke cannabis need to be viewed in that light



  1. Reminds me of when we only had shitty “ultra light” cigarettes left at the end of the night, we would rip the filters off to try to get a legit smoke.

    Comment by Comradde PhysioProffe — July 23, 2015 @ 9:03 am

  2. […] cause novel harms? In other words, presumably the nicotine harm is the same (once individuals learn how to get their desired nicotine dose from these). But are there constituents of the vehicles, the flavorants or products created by the […]

    Pingback by Vaping: Known Unknowns | Drugmonkey — December 21, 2015 @ 4:11 pm

RSS feed for comments on this post. TrackBack URI

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

Blog at

%d bloggers like this: